Individual
CANDACE H LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
344 E 4TH ST, JAMESTOWN, NY 14701-5502
(716) 661-1590
Mailing address
344 E 4TH ST, JAMESTOWN, NY 14701-5502
(716) 661-1590
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001774
NY
Other
Enumeration date
09/13/2007
Last updated
09/13/2007
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